CSF total protein
CSF total protein is a test to determine the amount of protein in cerebrospinal fluid (CSF). CSF is a clear fluid that is in the space around the spinal cord and brain.
How the Test is Performed
A sample of CSF is needed [1 to 5 milliliters (ml)]. Alumbar puncture (spinal tap) is the most common way to collect this sample. Rarely, other methods are used for collecting CSF such as:
- Cisternal puncture
- Ventricular puncture
- Removal of CSF from a tube that is already in the CSF, such as a shunt or ventricular drain.
After the sample is taken, it is sent to a lab for evaluation.
Why the Test is Performed
You may have this test to help diagnose:
- Inflammation of several groups of nerve cells
- Blood in the spinal fluid
- Multiple sclerosis (MS)
The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) or 0.15 to 0.6 milligrams per milliliter (mg/mL).
Normal value ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.
What Abnormal Results Mean
An abnormal protein level in the CSF suggests a problem in the central nervous system.
Increased protein level may be a sign of a tumor, bleeding, nerve inflammation, or injury. A blockage in the flow of spinal fluid can cause the rapid buildup of protein in the lower spinal area.
A decrease in protein level can mean your body is rapidly producing spinal fluid.
Deluca GC, Griggs RC. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 368.
Euerle BD. Spinal puncture and cerebrospinal fluid examination. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 60.
Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 88.
Last reviewed on: 4/21/2019
Reviewed by: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Stony Brook University School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.